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hemant kamble, Namrata Sharma, Gautam Sinha, Jeewan S Titiyal, Tushar Agarwal, Bhavna Chawla, Radhika Tandon, Rasik Behari Vajpayee; Demographic profile, clinical features and outcome of peripheral ulcerative keratitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5462.
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To evaluate the etiology, demographic profile, clinical features and management outcomes in cases of peripheral ulcerative keratitis (PUK).
Sixty five consecutive patients with PUK who presented to Cornea Services of a tertiary eye care centre in a period of 1 year.Seventy six eyes of 65 consecutive patients with PUK were evaluated, treated. Medical therapy included use of topical and systemic immunosuppresives and antimicrobial agents. Surgical treatment included conjunctival resection, amniotic membrane graft, tissue adhesives, penetrating keratoplasty, lamellar keratoplasty, and corneoscleral patch graft. Follow up was done daily during the first week, at 2 weeks, 1 month, 3 months, 6 months,1 year, 2 year and 3 years following treatment.
The main outcome measures were socio-demographic profile, etiology, clinical features, management strategies and outcome. Sixty percent (39/65) of the cases were males and the mean age of the patients was 45.5± 17.9 years. Two third (43/65) of the patients were from rural areas with majority (48/65) belonging to low socioeconomic status. Unilateral disease was present in 83% of patients (54/65) with nasal involvement observed in 60.5% (46/76) of. The most common etiology was Mooren’s ulcer present in 31.5% cases (24/76 eyes) followed by microbiological infection and systemic collagen vascular disease. Meibomian gland dysfunction (17/76: 22.3%) was the commonest extraocular association and complicated cataract (12/76: 15.7%) was the commonest intraocular abnormality. In mild and moderate cases, no significant visual improvement was observed (p= 0.085 and p= 0.156) as compared to the pre treatment status. Surgical treatment was successful in maintaining anatomical integrity in 83.3 % (30/36) eyes. Recurrence of the disease was seen in one eye in moderate disease and 3 eyes in severe disease.
Mooren’s ulcer followed by collagen vascular diseases and infection are important causes of PUK in developing countries. Surgical intervention in perforated cases had good anatomical success and visual prognosis.
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